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NPI Code Detail

MEDICARE: DR. DEXTER BERLIN DAFNEY DDS

MEDICARE: DR. DEXTER BERLIN DAFNEY DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry34124TX

General Provider Information

NPI Number : 1295228146
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEXTER BERLIN DAFNEY DDS
Provider Business Mailing Address
First Line : 316 RADAR RD
Second Line :
City : LONGVIEW
State : TX
Zip : 75603-7400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3080 N EASTMAN RD
Second Line :
City : LONGVIEW
State : TX
Zip : 75605-5174
Country : US
Telephone Number : 903-871-5602
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2018
Last Update Date : 06/14/2018

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Directions to “ DR. DEXTER BERLIN DAFNEY DDS” Practice Location

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